Medicine
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This repository contains the published and unpublished research of the Faculty of Medicine by the staff members of the faculty
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Item Composite carotid intima-media thickness as a risk predictor of coronary heart disease in a selected population in Sri Lanka(Public Library of Science,, 2022) Abeysuriya, V.; Wijesinha, N.A.I.; Priyadharshan, P.P.; Chandrasena, L.G.; Wickremasinghe, A.R.Background: Segment-specific variations of carotid intima-media thickness (CIMT) have not been assessed in South Asian populations. The purpose of this study was to determine if segment-specific CIMTs or a composite-CIMT score is a better risk predictor of coronary heart disease in South Asian populations. Methods: A comparative prospective study was conducted from November 2019 to October 2020 in a hospital in Colombo, Sri Lanka. Based on pre-defined inclusion and exclusion criteria, cases (having a diagnosis of Coronary Heart Disease (CHD), n = 338) and controls (non-CHD group, n = 356) were recruited. Ultrasound examination of the common carotid (CCA), the carotid bulb (CB) and the internal carotid segments (ICA) of the carotid vessels was conducted by a radiologist, and CIMTs were measured. A composite-CIMT score defined as the average value of all six segments of the left and right sides was derived. Results: 694 participants were enrolled (male n = 399, 57.5%). The mean (±SD) age of the study sample was 60.2 (±9.86) years. There were variations in segment-specific values between the left and right vessels. The mean composite-CIMT value of the CHD group was significantly higher than that of the non-CHD group. A composite-CIMT score of 0.758 had a sensitivity of 98.4% and a specificity of 64.6% in distinguishing CHD from non-CHD groups (Area under the curve (AUC): 0.926). Conclusions: Carotid artery segment-specific CIMT variations were present in this population. The composite CIMT score is better than segment-specific CIMTs in predicting CHD and may be used to predict CHD in this population.Item Serum cystatin C as a marker to identify patients with moderately impaired renal function(Association of Clinical Biochemists of India,, 2008) Peiris, H.; Chandrasena, L.G.; Lanerolle, R.D.ABSTRACT: The low molecular weight protein cystatin C produced by all nucleated cells and eliminated by glomerular filtration is of special benefit as a marker of renal function. A study was therefore undertaken to investigate whether serum cystatin C could be used as a marker to identify patients with moderately impaired renal function. A cross-sectional descriptive hospital based study was carried out and serum cystatin C was measured in fifty subjects aged 12 to 74 years with a 24 hr creatinine clearance estimation done at the same time. The gold standard creatinine clearance was used to compare the predicted glomerular filtration rate measured using serum cystatin C. Predicted glomerular filtration rate gave a sensitivity of 82% and specificity of 68% with a diagnostic cut-off value of 1.25mg/L cystatin C for identification of patients with moderately impaired renal function with a single random blood sample. AUTHOR KEYWORDS: Creatinine; Cystatin C; Glomerular filtration rate; Moderately impaired renal functionItem The role of antioxidants in filarial infection(Royal Society of tropical medicine and Higiene (RSTMH), American Society of tropical medicine and Higiene(ASTMH), British Society for Parasitology, 2000) Premaratna, R.; Chandrasena, T.G.A.N.; Senarath, S.; Chandrasena, L.G.; de Silva, N.R.; de Silva, H.J.Abstract AvailableItem Clearance of microfilaraemia and red blood cell glutathione peroxidase(GPX) levels in asymptomatic microfilaraemics after single dose and 14 days’ treatment with diethyl carbamazine citrate(DEC) (Sri Lanka Medical Association, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.Abstract AvailableItem Clearance of microfilaraemia and red blood cell glutathione peroxidase(GPX) levels in asymptomatic microfilaraemics after single dose and 14 days’ treatment with diethyl carbamazine citrate(DEC)(Wiley, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.Abstract AvailableItem Red blood cell antioxidant levels after treatment with diethyl carbamazine(Wiley, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.Abstract AvailableItem Red blood cell antioxidant levels after treatment with diethyl carbamazine citrate in persons with asymptomatic microfilaraemia(Sri Lanka Medical Association, 2001) Premaratna, R.; Chandrasena, T.G.A.N.; Abeyewickreme, W.; de Silva, N.R.; Chandrasena, L.G.; de Silva, H.J.Abstract AvailableItem Role of antioxidants in filar1al infection(Sri Lanka Medical Association, 2000) Premaratna, B.A.H.R.; Chandrasena, T.G.A.N.; Senerath, G.L.C.S.; Chandrasena, L.G.; de Silva, N.R.; de Silva, H.J.Abstracts AvailableItem Outcome of patients with ST segment elevation myocardial infarction (STEMI) following percutaneous transluminal coronary angioplasty: a retrospective study(Sri Lanka Medical Association, 2014) Abeysuriya, V.; Chandrasena, L.G.; Kasturiratne, A.; Hettiarachchi, V.S.; Wickremasinghe, A.R.OBJECTIVES: To study the characteristics and long term outcome of patients who had segment elevation myocardial infarction (STEMI) and treated with PTCA in a fee levying hospital in Sri Lanka. METHODS: A retrospective study was conducted among patients diagnosed with STEMI and treated with PTCA in a fee levying private hospital in Colombo from 1st January 2009 to 1st November 2012. Details of patients were obtained from medical records and the survival status, cause of death and date of death where relevant, were obtained from records, patients or close relatives. RESULTS: 197 patients (153 men; 77.7%) were included. More than 50% had a history of diabetes, dyslipidaemia or hypertension. The three year survival was 82.7% (95% CI: 77.9%-90.5%). Based on the Cox's Proportional Hazards model, site of arterial occlusion (proximal vs distal segment of left anterior descending artery [LAD] was significantly associated with mortality due to all causes [HR 10.98; 95% CI: 1.09-110.20]. Low ejection fraction, not on regular medication and delay of more than 3 hours between onset to door time were associated with death due to cardiovascular causes in patients whose right coronary artery or left circumflex artery was the culprit artery. CONCLUSIONS: The three year survival of patients with STEMI and who had PTCA was 83%. Patients with proximal LAD occlusion were 11 times more likely to die within 3 years of PTCA as compared to those who had a distal LAD occlusion.